Journal of Family Medicine and Primary Care

ORIGINAL ARTICLE
Year
: 2015  |  Volume : 4  |  Issue : 3  |  Page : 416--421

Treatment of uncomplicated symptomatic urinary tract infections: Resistance patterns and misuse of antibiotics


Carolin Elizabeth George, Gift Norman, G Venkata Ramana, Devashri Mukherjee, Tata Rao 
 Department of Community Health and Family Medicine, Bangalore Baptist Hospital, Hebbal, Bellary Road, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Carolin Elizabeth George
Department of Community Health and Family Medicine, Bangalore Baptist Hospital, Hebbal, Bellary Road, Bengaluru - 560 024, Karnataka
India

Introduction: Uncomplicated but symptomatic urinary tract infections (UTIs) are a common problem seen in practice. The study was undertaken to assess the most common pathogens responsible for uncomplicated symptomatic UTIs and the antimicrobial resistance pattern in a hospital in Bangalore. The study also explores the issue of antibiotic usage for these patients. Materials and Methods: The study was conducted in the Medicine department of a tertiary hospital in Bangalore. In all, 196 patients presented with symptoms of UTI. Bacterial growth was determined by standard microbiology techniques on freshly voided mid-steam urine samples collected from recruited patients. Patients«SQ» demographic data, urine culture results, resistance rates to antimicrobial agents and prescribed empiric antimicrobial therapy were analyzed. Results: The prevalence of UTI was 32.1%; majority (67.9%) of the symptomatic did not have UTI based on culture report. Gram-negative bacteria constituted the largest group with a prevalence of 84.1% (53/63), with Escherichia coli being the most common (70%) uropathogen. Gram-negative isolates showed high level of sensitivity to amikacin (90.6%) and nitrofurantoin (77.4%). Most of the gram-positive organisms were susceptible to nitrofurantoin (70%) and gentamicin (50%). Uropathogens isolated demonstrated high resistance to cotrimoxazole, fluoroquinolones, and beta-lactam antibiotics. It was found out that 30.1% of the patients were wrongly managed of which 14.7% were over treated. Conclusion: UTI can be over diagnosed and over treated on the basis of clinical signs, symptoms and urine microscopy. In the era of emerging anti-microbial resistance, effective counseling and delay in antibiotic initiation or empirical therapy with a short course of nitrofurantoin is highly recommended. Empirical therapy guidelines should be updated periodically to reflect changes in antimicrobial resistance of uropathogens.


How to cite this article:
George CE, Norman G, Ramana G V, Mukherjee D, Rao T. Treatment of uncomplicated symptomatic urinary tract infections: Resistance patterns and misuse of antibiotics.J Family Med Prim Care 2015;4:416-421


How to cite this URL:
George CE, Norman G, Ramana G V, Mukherjee D, Rao T. Treatment of uncomplicated symptomatic urinary tract infections: Resistance patterns and misuse of antibiotics. J Family Med Prim Care [serial online] 2015 [cited 2020 Jul 2 ];4:416-421
Available from: http://www.jfmpc.com/article.asp?issn=2249-4863;year=2015;volume=4;issue=3;spage=416;epage=421;aulast=George;type=0